A new study led by the University of Toronto Researchers reveals that operative teams having a critical mass of female anaesthesiologists and surgeons can reduce postoperative complications. Published in the British Journal of Surgery in May highlights a vital step forward in improving both patient outcomes and diversity in surgery.

The study, titled ‘Association between anaesthesia–surgery team sex diversity and major morbidity’, indicates that surgical teams including more female representation improves patient outcomes and lowers the risk of serious complications – and therefore could reduce healthcare costs and waiting times.

The study was undertaken with the aim to statistically demonstrate the importance of diversity within surgery beyond the need for equity and social equality: “The need for team diversity is an evolving conversation, initially rooted in notions of representation and social justice. Diversity is not solely a social and ethical imperative, but can also be a catalyst for improved performance.”

“In various sectors, such as business, finance, industry, technology, education, and music, gender and sex diversity is a strategic resource that enriches the output of teams through a multiplicity of experiences and viewpoints. However, there is limited evidence for the value of sex diversity of teams in healthcare, with published reports to date focusing on individual’s characteristics and their associations with outcomes.”

Spanning a decade and over 700,000 operations the study is the world’s largest of its kind. In it, researchers analyse 709,899 elective operations that took place in 88 hospitals in Ontario, Canada, between 2009 and 2019.

According to the published results, “Of 709 899 index operations performed at 88 hospitals, 90-day major morbidity occurred in 14.4%. The median proportion of female anaesthetists and surgeons was 28 (interquartile range 25–31)% per hospital per year.”

“Care in hospitals with higher sex diversity (over 35% female) was associated with reduced odds of 90-day major morbidity…The magnitude of this association was greater for patients treated by female anaesthetists…and female surgeons”

In the face of these results, the study concludes: “The main takeaway for clinical practice and health policy is that increasing operating room teams’ sex diversity is not a question of representation or social justice, but an important part of optimising performance.”

“Healthcare institutions should intentionally foster sex diversity in operating room teams to potentially reduce major morbidity, which, in turn, can enhance patient satisfaction and reduce costs.”

Dr Julie Hallet, the lead author of the study at the University of Toronto, furthers this message, stating, “Ensuring a critical mass of female anaesthesiologists and surgeons in operative teams isn’t just about equity; it seems necessary to optimise performance.”

“These results are the start of an important shift in understanding the way in which diversity contributes to quality in perioperative care.”

Read the full study